Hypertension and ethnic group: Eplerenone may have role in hypertension related atrial fibrillation

doi:10.1136/bmj.332.7547.974-b

BMJ 2006;332:974 (22 April), doi:10.1136/bmj.332.7547.974-b

Letter

Hypertension and ethnic group

Eplerenone may have role in hypertension related atrial fibrillation

The first 150 words of the full text of this article appear below.

EDITOR—Notwithstanding the fact that the preferred optionfor black people is the antihypertensive drug regimen comprisingcalcium channel blockers and diuretics,¹ adjunctive treatmentthat reduces the risk of hypertension related atrial fibrillationalso needs to be considered.

On meta-analysis, angiotensin converting enzyme (ACE) inhibitors,as well as angiotensin receptor blockers, have this effect.²The focus must now be on the blockade of those components ofthe renin-angiotensinaldosterone system that are "race neutral."Promising results come from a study comprising at least 409patients, including subgroups in whom 15-25% of the subjectswere black. In that study, a blood pressure lowering effectattributable to the aldosterone blocker eplerenone was documentedin white as well as black people.³

In a smaller study, in which patient subgroups were characterisedby a 4-6% content of black people, the adjunctive use of eplerenoneenhanced the antihypertensive effect of ACE inhibitors and angiotensinreceptor . . . [Full text of this article]

Oscar M Jolobe, retired geriatrician

Didsbury M20 2RN oscarjolobe@yahoo.co.uk